Surgical drainage tube



April 22, 1952 D. J. CALICCHIO 2,593,980

SURGICAL DRAINAGE TUBE Filed July 19, 1950 Inventor David J Gal/calm? byMam/ Qua Attorneys Patented Apr. 22, 1952 UNI TED STATES PATENT- OFFICESURGICAL DRAINAGE TUBE David J. Caliochio, Boston, Mass. ApplicationJuly19, 1950, Serial No. 174,695

The presentinventionrelates to surgery; Afteran abdominal operation, gasand other fluids usually collect in the gastro-intestinal tract, causingdistentiomwith resulting gas painsv sary to thread the tube through thenos or the mouth into the stomach, and through the stomach into theintestines; then 'to ,keep the parts external to the patientin properposition for perhaps several days, during both waking and sleepinghours; and, finally, after :the distention has disappeared, to pull thetubetout again, This does not add tosthe comfort of thezpatient duringthe after-effects ofthe operation..

Ancbject of the presentinventionis to improve upon present-daymethodsiof post-operative care of the patient, with the end in View ofeither eliminating altogether the necessity forthreading thedrainagetube through the mouth or the nose, or, if it is decidedto"employ it, to avoid the necessity for withdrawing it later from thepatients interior.

Another object is to provide a new and improved drainage tube.

Other and further objects will be explained hereinafter,-and will beparticularly pointed out in the appended claims.

With the above objects in view, a feature of the invention resides in adrainage tube of absorbable material, such as plain or chromic catgut;One end of this tube of absorbable material is inserted into thestomach, or the bowel, or both at the very time of the operation; and,according to a feature of the invention, it is inserted, not through themouth or the nose, but directly through an opening that the surgeondeliberately cuts into the Wall of the stomach or the bowel at the timeof the operation, when such wall is accessible to the surgeon for makingthe cut. The drainage tube, so inserted in the stomach or the bowel, isleft in place at the time of the closure of the operative wound. Theother end of the drainage tube, led out from the patients interiorthrough a stab wound in the patients abdominal wall, is connected to aconventional pump, with aid of which the contents of the stomach or theintestine or both are removed, in the customary manner, during the nextseveral days, through perforations in the wall of the drainage tube. itis not necessary to add to the patients discomfort by finally removingthe drainage tube, however, because, by the time of the patients re- 2Claims. (Cl. 128-350) covery, his system will have-absorbed thematerialof .whichithe drainage tube is constituted.

According to another feature of the invention,

the surgeon" does not need tocut into the wall of the stomach or :theintestine during the operation. The drainage tube may be insertedpostoperatively; through the mouth, or the nose in.

the customary manner, Even in such cases, however, the advantageousfeature of the present in vention may still be employed; inthat it isnot necessary thereafter toremovethe drainage tube from thepatientssystem, because itwill have become absorbed ,during the-periodof'the patient's recovery;

The invention will now be described morefully in connection with theaccompanying drawings,

in which Fig. 1 is a diagrammatic perspective showing a drainage tubeembodying'the present invention inserted into a patients intestine, in

accordance with a feature of the present inven;

the method, involving the tieing of the free end,

of the drainage tube after the patients abdominal distention hasdisappeared; and Fig. 4 is an elevation illustrating a modified methodaccordingto the present invention.

The drainage tube of the present invention isconstituted of a materialthat is absorbable by the human system, such as plain or chromic catgut.It is made in various lengths and different diameters, depending uponthe particular use to which it maybe put. One end 2 of the drainage tube5 is shown provided with a plurality of perforations, for a purpose tobe presently described. This end 2 of the drainage tube l is shown open,but it may be expanded into a perforated ball, not shown, at its verytip. It is shown single-compartmented, but it may be longitudinallydivided into two compartments, one for suction and the other forinflation.

During the performance of an abdominal surgical operation, at a timewhen the walls of the operative wound E in the abdomen 8 of the patient23 are held open by retractors I, the

surgeon, in accordance with a feature of the invention, temporarilyinterrupts the operation to make a small puncture incision 3 in theanterior wall of the small bowel 5 or the stomach 26 or any otherviscus. Where the incision 3 is made depends upon the location that thesurgeon may desire to deflate. He then inserts one end 2 of the drainagetube I through the opening in the viscus produced by the incision 3. Ifhe should produce the incision 3 in the stomach 26, for example, hewould thread the end 2 of the drainage tube I into the stomach 2B and,through the pylorus 27, as far down into the small bowel as he mayconsider to be desirable. By providing a sufiicient length of the end 2of the drainage tube I with perforations, this will enable draining boththe stomach 26 and any desired length of the small intestine 5. TheWalls of the opening in the viscus produced by the incision 3 are closedaround the drainage tube with the aid of suitable stitching material 4.In Figs. 1 and 2, the stitching material 4 is shown producing apurse-string suture. The purse-string suture may be reinforced byseveral additional interrupted sutures, not shown. A tab of omentum maybe patched around the opening produced by the incision 3 to seal it morepromptly, but this is omitted from the drawings, in order to simplifythe disclosure.

The other end of the drainage tube may be brought out from the interiorof the patient 23 either through the same surgical incision, 6 orthrough an additional stab-wound incision 8 in the abdominal wall, afterwhich the surgeon pro ceeds with the operation, ultimately closing saidsurgical wound 6 at II. The other end of the drainage tube I is thenconnected to a drainage pump in any well known manner for which reasonit is shown unperforated. As an illustration, the said other end of thedrainage tube I is shown connected by means of a glass tube 22 to oneend of a rubber hose 2| the other end of which, together with one end ofa rubber hose I8, are shown connected at I9 to a vacuum vessel 20. Theother end of the rubber tube l8 and one end of a rubber tube It areshown connected at I5 to an inverted liquid-containing vessel I2provided with a vertically disposed glass tube I3, the lower end ofwhich is connected to the rubber tube I8, and a vertically disposedglass tube I4 the lower end of which is connected to the said end of therubber tube I6. The upper ends of the glass tubes I3 and I4 are disposedrespectively above and below the level of the liquid in the vessel I2.As the liquid in the vessel I2 therefore tends to flow by gravitythrough the glass tube Id and the rubber tube It into a vessel l1 uponthe floor, below the patient, a vacuum tends to be produced above thelevel of the liquid in the vessel I2, resulting in the pumping out, bysuction in the vessels I2 and 20, of gas and liquid in the stomach 2B orthe intestine 5 or both through the perforations in the end 2 of thedrainage tube I.

' esophagus 25, into the stomach 26.

Stitching material 4 may, of course, be employed around the incision 9,as well as around the incision 3.

When the patient 23 has recovered sufficiently so that drainage ordecompression is no longer needed, the drainage tube I is disconnectedfrom the pump, it is tied into a knot In close to the abdomen 8, and itsexcess above the knot I0 is cut away. It is not necessary to remove theportion of the drainage tube remaining in the patient, for it willbecome absorbed by his system, in the same manner that catgut suturesare absorbed.

According to another feature of the invention, illustrated in Fig. 4,the end 2 of the drainage tube I may be inserted into the stomach 26and, if desired, through the pylorus 21, into the intestine 5, by thecustomary method, dreaded by all patients, of threading it through thenose or mouth 2% and down the esophagus 25. In that event, of course, itis desirable that the drainage tube I be of the same small diameter asthe red rubber tubes that are customarily to-day passed through the noseor the mouth 24, down the The other end of the drainage tube I may beconnected to the pump in the same manner already described. ihe presentinvention has the advantage however, that, unlike present-day practice,it is not necessary to remove the drainage tube I, for it will becomeabsorbed.

Further modifications will occur to persons skilled in the art, and allsuch are considered to fall within the spirit and scope of theinvention, as defined in the appended claims.

What is claimed is:

1. A drainage tube of material that is absorbable by the human systemprovided with a plurality of perforations at one end and that isunperforated at its other end.

2. An absorbable catgut drainage tube provided with a plurality ofperforations at one end and that is unperforated at its other end.

I DAVID J. CALICCI-IIO.

REFERENCES CITED The following references are of record in the file ofthis patent:

UNITED STATES PATENTS Number Name Date 1,374,808 Bethune Apr. 12, 19212,127,903 Bowen Aug. 23, 1938 2,489,067 Wild Nov. 22, 1949 2,508,690Schmerl May 23, 1950

